**11. Concluding remarks**

Despite recent advances in the management of the majority of autoimmune diseases and the emergence of novel biological therapies, therapeutic options in SLE are rather limited. For over 50 years, and before the approval of belimumab, corticosteroids, antimalarians and traditional immunosuppressants were the only therapeutic options. This is probably due to the heterogeneity and multi-organ involvement of the disease, problems in study designs including too strict endpoints (such as no BILAG B and complete renal response), racial differences in terms of prognosis and treatment response, and the difficulty in the achievement of statistically significant difference when novel biological therapies are tested on top of the already effective, standard of care. Moreover, severely affected patients including patients with lupus nephritis and NPSLE are frequently excluded from RCTs, leading to a lack of information for these patients. Targeted treatment guided by patient's clinical and biological phenotype with the use of biomarkers and omics may result in an optimal management of the disease and achievement of remission.
